






























* ^ 

r * * * °* 




*< 

* 



*°« 




^ 



V\ 



> s • • . *>v /^V" v « „ ** 











a v "V j lliiilf° ^^ 'wW* a v -^. 

r > vCv « 







'b V 



1 <v* °°^ ^^°° A 




o > 




jp^ 



• ^ c.^ »J> 







o° ♦• 




o v 






$> 



6 b ^ 



\/ 










^ 



^0" 










^ 









.,* 



<a> r o « 






» / 



* * 



'**• 









*• ^ d>> *j 










Popularizing Health Conservation 



LEE K^RANKEL 
Sixth Vice-President Metropolitan Life Insurance Company 

New York 



A Paper Read before the American Life Convention 
St. Paul, Minn., August 19, 1913 



r 







Popularizing Health Conservation. 



In the invitation which Dr. Foxworthy extended to me to 
prepare a paper to be read before your body on the subject of 
Health Conservation, he suggested that, if possible, I show 
the economy of such activity on the part of life insurance com- 
panies. I take it that the day has passed when it is necessary 
to demonstrate the desirability of such effort on the part either 
of life insurance companies or other bodies. The various reports 
on health conservation, governmental and otherwise, which have 
been presented in the past few years show clearly that conscious 
constructive efforts in the direction of human life extension have 
brought about valuable results. It seems to be well assured that 
it is possible to increase the length of human life through a better 
knowledge of the causes which shorten life, particularly pre- 
ventable diseases, and by the education of the public in correct 
methods of living. 

As I have said, the question of the desirability of propaganda 
along human life extension lines leaves nothing further to be 
said. Whether action of this kind, however, on the part of life 
insurance companies is feasible is another question. I confess 
at the outset that I have little statistical data which proves or 
disproves this statement. My knowledge of the subject is 
limited largely to the work that has been done by the Metropolitan 
Life Insurance Company and the few other insurance companies 
that have entered this field. I am in hopes, however, that the 
other data which I can present to you to-day will indicate, if not 
prove, the advantage which accrues both to insurance companies 
and their policy-holders by concerted effort to educate the latter 
in human welfare work. The subject should really be considered 
from three viewpoints. First, the value of education in life 
conservation for the policy-holders ; second, the value to the agents ; 
and third, the value to the companies. I shall attempt to discuss 
these serially. 

l 



The Value of Health Conservation to Ordinary 

Policy-holders. 

In considering the subject from the standpoint of its value 
to policy-holders, we must further differentiate between so-called 
Ordinary policy-holders and Industrial policy-holders. It is 
questionable to what extent the former need further instruction 
on the part of the companies with which they are identified. As 
a rule, the individual who is in a position to take an Ordinary 
policy of $5,000 and upward is so circumstanced that he is in 
touch with movements which make for progress along health 
lines. He is apt to be a man of some education. He reads the 
newspapers, subscribes to magazines, comes in touch with other 
individuals who think, study and read, and frequently is identified 
with organizations and societies which have an active interest 
in humanitarian and welfare work. For the insurance company 
to attempt to bring further instruction to men of this class would 
in many instances be another illustration of "carrying coals to 
Newcastle." 

And yet it must be recognized that Ordinary policy-holders 
to-day are made up of a somewhat different stratum of society 
than was the case fifteen or twenty years ago. It is not uncommon, 
in fact quite common, for the artisan and for many individuals 
who earn their living in the trades to take policies from $1,000 
and upward. Our own experience with individuals who take 
insurance in amounts of $5,000 and upward indicates fairly well 
that these individuals are in a superior mortality class from those 
whose insurance policies vary from one to five thousand dollars. 
I think it is an axiom among medical examiners that the indi- 
vidual who carries a hundred-thousand-dollar policy is a worse 
moral hazard and gives a more unfavorable experience than the 
one who can carry only five thousand dollars of insurance. The 
group taking policies for about $1,000 has not as large opportunity 
to obtain useful instruction and information regarding the con- 
ditions under which they live and the rules and regulations which 
they should follow to enable them to extend their span of life. 
I think it is fair to say that for these it may be well worth while 
for an insurance company to undertake a campaign of instruction 
either by the dissemination of health literature, by periodical 
examination of policy-holders or in such manner as may suggest 
itself to the particular company. 

One fact, however, which has been well recognized by medical 

2 



directors and examiners everywhere should be mentioned at this 
point to illustrate why a health campaign may be desirable for 
Ordinary policy-holders of all kinds, and irrespective of the amounts 
of insurance which they carry. It is characteristic of human 
nature that the possession of wealth, while it gives the holder 
thereof opportunities for enjoyment, recreation, rest and leisure, 
in many instances leads to excess. The individual who must 
stint and save cannot indulge himself. His brother who is more 
fortunately situated with respect to worldly wealth often puts 
no bounds to gratifying his appetites. It is the general belief 
among students of the subject that mortality from diseases of 
the heart, arteriosclerosis, diabetes, Bright's disease and other 
degenerative diseases is higher among those who are in a position 
to live well and comfortably than among those to whom every 
dollar counts. I think the particular value of medical re-exami- 
nation of policy-holders will be demonstrated in this group who 
hold large policies. There is a possibility that when the danger 
signal has been shown to them through such re-examination they 
may have the intelligence to adopt a simpler mode of living. 

Welfare Work for Industrial Policy-holders, 

With respect to the Industrial policy-holder, the matter 
presents a somewhat different phase. As a rule, this group is 
made up of the working men of the community, and includes not 
only the male adults, but female adults and children of both sexes 
as well. To a considerable extent the working population is 
composed of recently arrived immigrants or of their descendants 
in the first generation. The opportunities which these men and 
women have had with respect to schooling have been limited. 
Their knowledge of language, customs and traditions is equally 
limited. They come frequently from countries in which living 
conditions have been below standard. Their ideas of cleanliness 
and health are vague and frequently incorrect. To what extent 
this element is present in the population is shown by the fact 
that much of the literature which the Metropolitan Life Insurance 
Company distributes to its Industrial policy-holders must be 
translated into ten different languages in order to be of service. 

You will see from what I have said that there is a distinct 
field of opportunity for Industrial insurance companies to educate 
their policy-holders along health lines. Such education would 
follow quite a number of directions. I need not recall to you 

3 



gentlemen, who are probably conversant with the subject, the 
fact that the Industrial mortality is considerably higher than that 
of the American Experience Table. At some ages, in fact, it is 
150 per cent, of the Ordinary mortality. Nor can we say that 
this excessive mortality is due to the fact that medical inspection 
only is made at the time the policy is issued. The experience 
of certain European insurance companies who issue Industrial 
policies with and without examination has demonstrated, odd 
as it may seem, that individuals who insure without medical 
examination or inspection, and whose policies come into full 
benefit only after they are one or two years old, have a more 
favorable mortality than policy-holders of the same group who 
have passed a medical examination and as a result have immediately 
had their policies in full benefit. This shows quite clearly that 
there is a distinct selection against the company on the part of 
individuals who are probably sub-standard lives but whose 
condition is not revealed by the medical examinations which are 
made. 

The causes of the higher mortality in the Industrial group 
must be looked for in their environment. I believe that such 
excessive mortality is primarily traceable to occupation. Long 
hours of work, hazardous industries, overstrain, combined with 
insufficient recreation and amusement, unquestionably sap the 
vitality of men and make them die earlier than they should. 
The German statistics of accidents show these facts very clearly. 
Generally speaking, it may be said that there are more accidents 
occurring at the end of the week than at the beginning or during 
the week. In other words, the effects of continuous labor and 
the consequent and subsequent wear and tear, both on the muscular 
and nervous system, develop a lassitude which makes for care- 
lessness and resulting accidents. Other causes which may be 
mentioned as producing higher mortality are housing conditions, 
inadequate wages, insufficient nourishment, overcrowding both 
in homes and in factories. All these combined make a determining 
factor bringing about higher mortality in the Industrial group. 

If we study the situation by age periods, this fact is even more 
pronounced. The mortality which our Company experiences 
in its Industrial department from tuberculosis (all forms) is 16.37 
per cent, of all deaths. On the other hand, at the age period 
20-24 the mortality is 43.61 per cent, of the total deaths. Similar 
figures are brought out at the various ages by the study of 

4 



other causes of death, particularly those directly traceable to 
occupation. 

Whether, therefore, the present mortality among policy- 
holders is due to the individual's own recklessness and extravagant 
methods of living, as is instanced by many Ordinary policy- 
holders, or whether he is a creature of his environment, as is the 
case with a large bulk of Industrial policy-holders, the fact remains 
that both of them need enlightenment and instruction. I take 
it to be the proper sphere of an insurance company to undertake 
this education. Its immediate value for the life insurance com- 
pany is reduction in mortality, which, in the last analysis, means 
a reduction of premiums or an increased amount of insurance for 
existing premiums. 

The studies which the Metropolitan Life Insurance Company 
has made from time to time of its Industrial mortality experience 
have demonstrated a constant improvement. As a result, the 
Company has twice, since 1907, increased the amount of benefits 
to its Industrial policy-holders. Similarly, the large bonuses 
which it has been distributing to its policy-holders annually for 
a number of years have been possible partly through the more 
favorable mortality in the Industrial group. This, I should say, 
has been the result of the general improvement in health con- 
ditions. Factory legislation, tenement house legislation, the 
raising of standards of living have all aided. We are of the 
impression that we are justified in supplementing these general 
movements for the improvement of health conditions by the 
campaign which we have had in effect now for some years, 
directed, however, exclusively to our Industrial policy-holders. 

Results Accomplished by the Metropolitan. 

You will be desirous of knowing what results have been accom- 
plished. As I have said at the outset, there is no statistical 
data at hand to indicate whether there has been any financial 
economy in the movement. I doubt, in fact, whether our mortality 
statistics within the next ten years will show the results of such 
a campaign. It is questionable whether they will ever be able 
to show any marked change as a result of our activities. Mor- 
tality, as you know, is affected by many conditions, over most 
of which we have no control. Whereas mortality in certain 
localities may show improvement, floods, epidemics and other 
adverse influence may be at work in other localities to keep the 

5 



general death rate about the same. It may be said here that at 
no time has the Company expected its welfare work among 
policy-holders to give a return measurable in dollars and cents. 
It has assumed the financial burden in the belief that its relation 
to its Industrial policy-holders was something more than a con- 
tractual one. The Industrial insurance agent who visits his 
policy-holders weekly is more than a canvasser. Insurance to 
the average working man has been a matter of indifference, and 
frequently of contempt or fear. The Industrial insurance agent, for 
this reason, has possibly even more of a mission as an educator 
in providence and forethought than falls to the lot of the Ordinary 
agent. Similarly, we feel that as trustees of the hard-earned 
savings of working men it is our business as an insurance company 
not merely to pay death claims as they arise, but to attempt to 
put off the payment period as long as possible. This latter 
statement may sound mercenary; as a matter of fact it is just 
the opposite. Few claims that have ever been paid to the families 
of working men have ever compensated them for the loss of the 
wage-earners and of their wages. If we can assist in prolonging 
the period of efficiency for the average working man. so that 
his family benefits thereby, we believe we are properly fulfilling 
our function as an insurance company for the masses of the popu- 
lation. 

If we can, as I say, prove nothing at the present time with 
respect to the economic value of welfare work, it is, however, 
proven that such work is distinctly appreciated by policy-holders. 
One of the objections to life insurance as prosecuted by life insur- 
ance companies is due to its inherent limitations and inability to 
bring policy-holder and company into closer contact. In this 
respect, as compared with the large fraternal orders, it has signally 
failed. To the average policy-holder the average insurance 
company is looked upon generally with a rather distinct belief 
in its solvency and ability to meet death claims, and at the same 
time with an air of scepticism as to its motives and willingness 
to give him a much-needed commodity at the lowest cost to him- 
self. The officers of an insurance company ordinarily are unknown 
to policy-holders excepting in the printed pages of annual reports. 
Even the agent, the intermediary of the company (excepting in 
Industrial insurance) , is known to the policy-holder mainly at the 
time when the application is signed or the claim is paid. Most 
frequently the agent represents to the policy-holder an individual 

6 



whom he is glad to get rid of for fear that he may be induced, against 
his desire or belief, to take out additional insurance. 

Our welfare work among Industrial policy-holders is putting 
a new phase to this relation between policy-holders and company. 
We find them distinctly appreciative of the efforts which we are 
making in their behalf. It is not uncommon for them to laud the 
Company and to praise its activities. We believe that in the long 
run we shall develop a group of policy-holders more satisfied to 
be policy-holders than they ever were. We believe that continued 
effort along welfare lines will make policy-holders realize more 
thoroughly than they ever did that even corporations have souls. 
It is our opinion, gained from our experience, that our policy- 
holders may be educated along the lines we have planned for 
them, and that they are willing as policy-holders to act concertedly 
for their common good. We have mentioned in other places 
the attempt which we made in 191 1 to secure a Federal department 
of health. It was a comparatively simple matter to bring this 
desire on our part to the notice of our Industrial policy-holders, 
and to show them, through literature specially prepared for the 
purpose , how desirable it was for their personal good to advocate 
such a department. As a result, thousands of our policy-holders 
communicated their wishes to their respective Congressmen, 
and it is admitted that this campaign materially forwarded the 
possibilities of national legislation directed toward the establish- 
ment of either a Federal department or bureau of health. 

Outings for Policy-holders. 

During the present summer we have endeavored to extend 
this sense of relationship between policy-holders and agents in a 
rather novel manner. Circular letters were sent to our super- 
intendents advising them that if they could arrange outings 
for policy-holders the Company was prepared to contribute 
a portion of the expense. We were led to this action by the 
splendid results obtained by such an outing in the city of St. Louis 
last year. In one district in that city the superintendent and his 
agents gave a picnic at which it was estimated 40,000 policy-holders 
were present. In fact, so great was the crowd that the street car 
system of St. Louis on that day was at its wit's end to meet the 
demands made upon it. Prizes of various kinds were offered; 
policy-holders indulged in a variety of sports and were given free 
admission to the various amusements in the amusement park 



in which the picnic was held. Ever since last summer the policy- 
holders in this district have been making inquiries at the district 
office to learn whether another picnic would be given to them 
this year. Plans have just been completed to hold another picnic 
in St. Louis on August 15th. 

A number of picnics of this kind have been given by superin- 
tendents in other cities this summer with most excellent results. 
Not only have policy-holders participated in these outings, but 
the motive which actuated the Company in giving them has won 
the commendations of city officials, including mayors and health 
officers, who have attended the same and made addresses. All 
of which simply proves what I have attempted to demonstrate, 
namely, that the social side of life insurance is one that may not 
be ignored and one which will bear definite fruits. I think you 
will agree with me that the policy-holders who have attended these 
picnics feel a sense of obligation to the Company; that they 
realize the efforts which the Company is putting forth in their 
behalf; that the tendency to lapsation on their part is distinctly 
minimized, and that the publicity that these policy-holders give 
to this form of welfare work is distinctly beneficial both to them 
and to the Company. 

If I have dwelt on this phase of the subject somewhat at 
length it is because I believe in its essential merit. When work 
of this kind is attempted, the relation between the policy-holder 
and the Company is no longer an abstract but a concrete one. 
The fact that the policy-holder speaks of the Company as "my 
Company" or as "our Company" shows the revulsion in feeling 
which has taken place. The possibilities of work along these 
lines are many. We have had under careful consideration for 
some time the question of bringing policy-holders together at 
periodical intervals and giving them lectures on health subjects 
and on other subjects of vital interest to them. The only diffi- 
culty in the way to date is the expense. Such a plan would 
involve the employment of competent lecturers, the rent of halls 
and other expense which, as we see it now, is not feasible. Purely 
on experimental lines, we have at various times arranged meetings 
at our district offices where mothers have been instructed by our 
nurses regarding the care of their children. The success of this 
experiment leads us to believe that it is well worthy of further 
extension. 



The Health and Happiness League. 

A little over a year ago, in our effort to get into closer personal 
touch with children who are policy-holders in the Company, we 
organized the Health and Happiness League. Children who 
desired to join this League were required to sign a pledge in which 
they promised to do certain definite things for the improvement 
of their bodily health and to co-operate with the Company in its 
welfare work. The members of this League receive a League 
button and a membership certificate. Practically without effort 
on our part, approximately one hundred thousand children are 
enrolled as members of the League. We are now engaged in 
devising plans to make the League a practical body of efficient 
workers for the betterment and improvement of health conditions. 

It is difficult to determine the economic value to the insurance 
company of welfare work such as has been indicated above; it is 
even more difficult to determine the value of an educational 
campaign carried on through the distribution of pamphlets, 
leaflets, etc. There is no means of checking up such a campaign, 
or at least none the cost of which would not be prohibitive. A 
considerable part of our welfare campaign has consisted of the 
distribution to our Industrial policy-holders of pamphlets on 
tuberculosis, the care of the child, teeth, tonsils and adenoids, and 
a more recent one on the health of the worker. We have now 
in preparation a pamphlet on first aid in the home, and a series 
of leaflets on preventable diseases such as smallpox, diphtheria, 
scarlet fever, etc. It is important, in connection with literature 
of this kind, that it should be written in a fashion that the average 
working man will read and understand. Unless it is put in an 
attractive form he will probably consign it, unread, to his waste- 
basket or garbage-pail. 

Health Literature. 

We have every reason to believe, however, that the literature 
which we distribute is read and that it has a distinct effect. Very 
recently a committee of midwives, with their counsel, requested 
an interview. This was granted to them. It appeared that they 
took exception to a statement contained in our pamphlet "The 
Child" in which the prospective mother was advised to have a 
doctor or to go to the hospital in preference to a midwife. The 
committee contended that this statement was ruining their busi- 
ness, since whenever they entered the homes of our policy-holders 



they were shown a copy of the booklet "The Child," and their 
attention directed to the statement respecting midwives. 
We feel that when policy-holders are sufficiently acquainted 
with the contents of our booklets to take an attitude of the 
kind described, such literature has a very distinct value. Other 
instances of the same kind could readily be cited. I need only 
mention the case of a mother who wrote to us that she had dis- 
charged her midwife because the latter had not carried out the 
instructions in our booklet with respect to the care of a baby's 
eyes. A father writes us that, prior to the receipt of our booklet 
"Teeth, Tonsils and Adenoids," it had never entered his mind 
to have his boy examined. When he did, he discovered that the 
boy had adenoids, which thereupon were removed. At various 
county fairs throughout the United States and Canada where 
the Company has exhibited its welfare work and distributed its 
literature, we have had the superintendents carefully watch to 
ascertain whether such literature was found lying around the fair 
grounds. It has been very gratifying to us to be informed 
that almost invariably the literature which we distributed was 
taken away by the visitors to these fairs. In fact, as a result of 
this distribution we have constant inquiries from the neighbors 
of individuals who have received our pamphlets requesting to be 
furnished with copies. 

The Visiting Nurse Service. 

The most important phase of our welfare work among policy- 
holders has been our visiting nurse service. Here, too, again, 
I must admit that we have no statistics which indicate whether 
this service, given voluntarily to policy-holders, has been instru- 
mental in materially reducing the mortality. On the other hand, 
we have instance after instance of individuals who have written 
to us of their belief that their lives have been saved by the service 
of the nurse; and nurses have reported instances of the saving 
of life. In our opinion, the value of this particular service, 
which to-day has been extended to practically all of our Industrial 
policy-holders, lies primarily in the realization on the part of the 
policy-holder that we are attempting to render him a service. 
He grasps the salient fact in the suggestion which we make to 
him in concrete form through the instrumentality of the nurse 
or in the literature which we hand to him through our agents, 
that our efforts are directed primarily for his benefit and his 

10 



improvement. In this way we secure his co-operation. In this 
way a bond of friendship is established between the Company and 
its policy-holders — a bond which we hope will be lasting and per- 
manent, if any effort on our part can make it so. 

Value of Conservation Campaign to Agents. 

Here, too, I can speak only from our own experience. This, 
I may say, has been not only distinctly favorable, but highly 
illuminating. We believe it no exaggeration to say that the 
co-operation which our agents have given us in our human life 
extension campaign has put them on a distinctly higher and better 
plane. The conscientious insurance agent's work is not exclusively 
to increase business. This is particularly true of the Industrial 
insurance agent who, in addition to his duties as canvasser, is 
required to act as collector of small weekly premiums. His work 
brings him constantly in contact with the working population. 
The work is hard and difficult, frequently trying and exasperating. 
The difficulties which the Industrial agent encounters are in many 
respects similar to those of all insurance agents. At one moment 
they reach the heights of delirious expectation, only to be cast 
down the next moment into the depth of disillusionment. Since 
the work of the Ordinary agent is on a commission basis, his 
income is an uncertain factor, and for this reason the pecuniary 
side of this work looms up in his horizon. 

I believe that our agents, as a result of their interest and activity 
in our welfare campaign, have unconsciously been made to realize 
the dignified character of the work in which they are engaged, 
even more so than formerly. They have awakened to the fact 
that their labors are fundamentally altruistic. Life insurance 
is a profession, the advocates of which, aside from the fact that 
they earn their living therein, are educators in self-abnegation 
and self-sacrifice. The teachings of the doctrine of thrift, of 
provision for protection against important contingencies of life, 
are educational activities which make the work of the agent vie 
with that of the school teacher or the college professor. This in 
itself gives dignity to the work our insurance agents undertake. 
The activities we have assigned to them in our welfare campaign 
have added materially to the consciousness of our agents of the 
important part they play in the development of communal and 
civic activities for the betterment of their fellow citizens. Since 
we have undertaken this work, many of our agents and superin- 

11 



tendents have of their own initiative brought schemes for the 
improvement of existing conditions to the notice of officials in 
the cities in which they live. Only recently one of our agents 
wrote to us for full information regarding the establishment of 
free dispensaries. There was none in his city and he had interested 
the mayor and other officials in organizing one. 

We find that as a result of this work the relationship of agent 
to policy-holder is more that of a friend and adviser than one 
of cold formal business. The fact that it is the agent who dis- 
tributes health literature and explains the contents to his clientele 
gives him at once a standing in the household which we believe 
could not readily be gained by any other means. Incidentally, 
the conscientious agent, in order to fully carry out the ideas which 
prompt the Company to institute welfare work, must of necessity 
come in contact with representative individuals of his community 
engaged in similar social enterprises. We recently sent out a 
circular to our superintendents inviting them to advise us of the 
social and civic activities with which they were connected. The 
returns have been quite surprising and gratifying. Many of our 
superintendents are members of boards of trades and chambers 
of commerce in their respective cities; a number of them are 
identified with charitable and philanthropic institutions. Others 
are officers of or are on committees of civic bodies. 

Let me give you an illustration of the value of this work to 
the agent and to the superintendent. In the early spring we 
sent circulars to all our superintendents calling their attention 
to the house-cleaning campaign which had been instituted and 
organized by the health department of the city of New York. 
We suggested the desirability of a similar campaign in their own 
cities, and advised them to take the matter up either with the 
mayor or with the health officers. We have still to hear of an 
instance in which interviews were refused to our representative, 
or where the city officials were not heartily in sympathy with the 
attempt of the superintendent, under our instructions, to establish 
ideal conditions of cleanliness through a city-cleaning campaign. 
In a number of instances superintendents, at the request of their 
city officials, wrote to the Home Office for a description of the plan 
in use in New York, and for copies of the literature which we had 
distributed to our policy-holders asking them to co-operate with 
the health officials of the city to insure an efficient and effective 
house-cleaning campaign. 

12 



A Better Agency Force. 

You will note that throughout this paper I have endeavored 
to give you practical illustrations of the results which we have 
thus far accomplished. The conclusions which I have drawn are 
based upon the actual results obtained; the illustrations which 
have been given could be multiplied and multiplied. Summed up, 
we have no doubt that as a result of our campaign we have a better 
agency force than formerly. This does not necessarily mean 
better men. Our standard for agents has been high for years. 
It does mean, however, that we have a field force to-day equipped 
to handle life insurance as a social proposition rather than as a 
purely sordid business enterprise. The responsibility which the men 
feel toward the Company has grown and been accentuated. The 
work which they are able to do through our welfare campaign 
gives them a distinct status and standing in their communities. 
In what is distinctly a social era they are able to play their part 
as men and insurance agents. The educational value to the 
agents through a health conservation campaign means loyalty 
and pride in the Company, not to speak of the possibilities of 
increasing and bettering business. One illustration I can cite with 
respect to the latter. We are in daily receipt of applications 
from non-policy-holders throughout the United States and Canada 
asking for copies of our publications. These are always forwarded 
by us through the superintendent or agent. It is surprising to 
note the large number of instances in which the literature has been 
instrumental in obtaining new friends and policy-holders for the 
Company. Lastly, and probably of greatest importance with 
respect to the agent, is the realization on his part that he can 
make work of this kind his life work. He realizes the undesira- 
bility of constant change in occupation. The finaling of agents' 
accounts is becoming less and less, and we have with us to-day 
a body of men whose interests are the Company's interests, and 
the Company's interests only. For such a result alone, if it ac- 
complished nothing else, a welfare campaign would have proved 
its economic value. 

I can only take a word here to speak of the welfare campaign 
which we are carrying on for our employees, including our field 
staff. This has been developed in varying directions, and to-day 
has a wide application. We hope within the next few months to 
open our sanatorium for tuberculous employees at Mount Mc- 
Gregor, New York. This is the first attempt on the part of an 

13 



insurance company to make institutional provision for the care 
of its agents afflicted with tuberculosis. 

Vai.uk to the Company. 

Finally, the value of welfare work or conservation work, which- 
ever one may call it, to the insurance companies remains to be 
considered. It would seem as if this did not require any further 
elaboration in view of what has been said of the value of such 
work to the policy-holders and to agents. After all, an insurance 
company is something of an intangible thing. Primarily, it is 
the policy-holders who are the company. It is their funds which 
are accumulated; it is for their benefit and protection that the 
company exists. Nevertheless, there is a company viewpoint 
which may not be ignored; and when I speak of company in this 
sense, I speak of the officers who direct it. Welfare work from 
the standpoint of the officers spells reputation. By this I do not 
mean notoriety. Each and all of us, whatever our employment, 
desire to have a certain satisfaction from the work in which we 
are engaged — to receive a certain return for our labors. To some, 
the purely financial reward is sufficient; to others, the recognition 
on the part of their fellow men of the motives which inspire their 
work is all-compelling and all-sufficient. No insurance company's 
officials can long maintain its standing to whom its reputation 
is not as the breath in their nostrils. Life insurance companies 
may have their assets; the surplus may be large, the reserve fund 
ample to protect policy-holders. These, after all, are not matters 
of congratulation so much as they are requirements of law. If 
they did not exist the officers would be held accountable. It is 
the things which the company does over and above its legal 
requirements which place it in a category to receive consideration 
from thoughtful men and women. Any attempt on the part of 
an insurance company to show the community its highly laudable 
desire to consider policy-holders not as so many units who pay 
premiums, but as men and women whose physical welfare should 
be its concern, will give to the company a reputation for honest 
and fair dealing to which it would be justly entitled. 

In the past it has been the tendency of the public, the press and 
legislatures to deprecate the work done by insurance companies 
rather than to extol it. Even to-day it is not uncommon for a news- 
paper, in commenting upon the good work which an insurance com- 
pany may have done, to omit the name of the company for fear 

14 



that undue advertising and publicity maybe given to the company. 
On the other hand, it is equally not uncommon, and at the same 
time regrettable, that many newspapers do not hesitate to give the 
widest publicity to an insurance company if in the opinion of its 
editors it has been guilty of the least infraction of the law or has 
not done everything that the policy-holder might expect. From the 
purely utilitarian standpoint, welfare work among policy-holders 
has a distinct public value. When I speak of publicity, I refer to 
it in its highest sense. Charitable and philanthropic organizations, 
welfare movements of all kinds, do not hesitate to-day to advertise 
their activities in every possible way. Only a few days ago at 
a seashore hotel, fans were distributed at all the tables on which 
the summer work of one of our large New York charities was 
given in detail. Our newspapers from day to day show similar 
advertisement of other welfare and charitable movements. Prob- 
ably all of us frequently receive letters requesting our support 
and contributions for agencies of all kinds engaged in social uplift. 
Their success in securing support depends upon their ability to 
present to the public the results which they have obtained. Their 
standing in the community is based altogether upon the success 
with which they conduct their work. 

Since the life insurance companies to-day, in a certain sense, 
are great social institutions, it is only fitting that they too shall 
keep the public advised and acquainted with the attempts which 
are being made to improve the conditions of their policy-holders. 
It is significant to note that where this is done and where it is 
realized that this form of care for policy-holders is inspired by 
proper motives, the legitimate newspaper press of the country 
is prepared to give due credit. The life insurance companies of 
to-day are engaged in an honest business ; the competition between 
them is based on a gentleman's agreement. All are interested 
to the best of their ability in inculcating the principles of insurance 
among their constituents so that they may guard themselves 
against the hazards of life. The insurance companies equally 
with other social associations are entitled to the proper recog- 
nition of their services to the community by the press, the public 
and the legislatures. 

The Need of the Future. 

If it were necessary to cite another utilitarian reason for 
welfare work by insurance companies, the marked changes in 

15 



insurance thought in the past few years could be referred to. 
Insurance companies must watch closely the signs of the times. 
Even in the United States to-day one hears the advocates of State 
insurance and sees laws enacted authorizing such experiments. 
In Italy, life insurance has been taken entirely out of the hands 
of private corporations and been made a state monopoly. The 
threadbare discussion as to the need of an agency force constantly 
comes to the front. We constantly hear the opinion of tyros voiced 
that under state insurance a Utopian scheme can be developed 
in which the agent would no longer be necessary. It would seem 
that the results in England, in Belgium, in Wisconsin, and most 
recently the failure of the large insurance society in Diisseldorf, 
Germany, which attempted to do business largely without agents, 
would have given sufficient testimony as to the impracticability 
of such ventures. Nevertheless, the private insurance company 
is at the bar. Whether we are to have a continuance of private 
voluntary insurance or the introduction of compulsory insurance 
will, to my mind, depend entirely upon the way in which the 
private insurance companies conduct themselves and realize 
their responsibility and obligations to their policy-holders. 

The question may well be asked whether the smaller insurance 
companies with comparatively limited financial resources can 
undertake life extension work of the character indicated in this 
paper. I am of the impression that they can. It may be that 
their activities would necessarily be limited in proportion to their 
financial ability. If it is of interest to this meeting, I may say 
that I understand plans are on foot in the East to effect an 
organization which will enable all insurance companies to 
participate in this work of health conservation without the neces- 
sity of special machinery for each company. It is planned to 
organize an independent central organization; a business corpora- 
tion, as I understand it, whose purpose is to do for all companies, 
through a centralized system, what is at present being done by 
a number of individual companies. I am not at liberty at present 
to go into particulars. The project is not one that has been 
initiated by an insurance company. It is only because its pro- 
moters have consulted me that I happen to know about it. 

Whether such a centralized body, independent of all insurance 
companies, will be the medium through which the smaller com- 
panies can undertake welfare work or not I am not prepared to 
say. I mention the fact here simply to show that the question 

16 



of human life extension is in the foreground, and that evidently- 
reputable business men consider the subject of sufficient impor- 
tance to attempt to organize a health conservation movement on 
a purely business basis. 

I have detained you here overlong and doubtless wearied you. 
I am in hopes, however, that when you have left this meeting 
and are refreshed you will on second sober thought realize the 
value of the arguments which I have presented. No insurance 
company to-day can afford to ignore the possibilities that lie 
in welfare work for policy-holders. I have cited distinct utili- 
tarian and good business reasons why it is advisable for insurance 
companies to enter this field. The greatest reason, however, 
and one which overshadows all the others, is the responsibility 
which insurance managers owe to their policy-holders. The 
funds which insurance companies hold belong in the last analysis 
to their policy-holders. The latter have invested these in the 
main in a spirit of unselfishness and frequently of self-sacrifice. 
They are using the machinery of the company to make provision 
for themselves and their families against life's risks and accidents. 
The modern attitude of an insurance company toward the policy- 
holders is primarily one of stewardship. It is incumbent upon 
every company to live up to this sense of stewardship; to hold 
such as a sacred trust, and to do everything that lies in its power 
to improve and better the living conditions of its policy-holders. 



17 



^132 78 56/ 




N500 







A V ^ 
J> o«VJ9^\K* aV ">v 







9^ 










v tVw£»> ^ aP - 






* • 











* ^ Ap ^'^* ^ 

&• -^ c^ ^ccOfA° 



'^ 









■^ 

> ^MMS * 4 0. ' 

;.. ^ ^ .VdBw*. **. 



^ 



A 



V ^ 



A 



^ ^, 



'O . » * 






*o * y * °. 



^ 



^ 












?♦ ^ -^ 

A 




»?^ 











4 0. 



'of 



• 1 1 







4^ 




















**V» 



-1 cu 




*°^ 







o> *^ 








iP v., 





' ^ 



4°*. 











" *• * 4^> 





^0^ 




t> H ° 











>v 



A 




41 




*°^ 















4 P^ 

7> y<V «> 









